6^thInternational Conference on
Neurodegenerative Disorders & Stroke

Biography:

Esther Lim, MD, MBA is currently an associate professor of radiology at PCOM and works in collaboration with Dr Hui Mao, PhD, Professor of Radiology and Biomedical Engineering and the Director for the Molecular Imaging, Biomarkers, and Probe Development at Emory University.  Dr Yuanchen Li, PhD is a staff scientist at Emory University School of Medicine with expertise in anti-biofouling polymer synthesis for nanomaterial coating and biomarker targeted imaging, drug delivery and therapy. 

Abstract:

Alzheimer’s Disease (AD) imposes a huge economic burden with its diagnostic and therapeutic challenges.  The currently available diagnostic tools are expensive, invasive, and insufficient for early screening.  At present, levels of amyloid-β (Aβ) in the brain can only be assessed reliably via Positron Emission Tomography (PET) imaging or by measuring amyloid-β (Aβ) levels in the cerebrospinal fluid. However, such invasive and expensive approach is impractical for patients with no obvious symptoms. Recent literature demonstrating the potential clinical utility of plasma biomarkers in predicting brain amyloid-β (Aβ) burden has drawn increasing interest among nanoparticle researchers. Development of minimally invasive and ultrasensitive detection system for early diagnosis of AD is critical for formulating optimal therapeutic strategies early in the progression of the disease.  Using anti-biofouling magnetic nanomaterials, we have constructed a novel, simple and efficient method that could serve as a screening tool.

The anti-biofouling polymer coated Iron Oxide Nanoparticles and their targeting antibody conjugates were prepared as described in the literature.  The Fluorescein Isothiocyanate (FITC) labeled amyloid-beta peptide 1-40 [Aβ(1–40)] and Tetramethylrhodamine-5-(and6)-isothiocyanate (TRITC) labeled peptide 1-42 [Aβ(1–42)] were dissolved in Phosphate Buffered Saline (PBS) with Fetal Bovine Serum (FBS) at 50mg/mL to mimic the human serum environment.  They were then incubated with antibody (Ab)-conjugated IONPs (at final iron concentration of 0.2 mg/mL) or antibody- conjugated Dynabeads for 3 hours before magnetic separation of particles.  The separation efficiency (SE) was calculated as the weight ratio of captured peptide to spiked.  The protein quantification was verified using micro bicinchoninic acid (BCA) protein assay kit.  Furthermore, insulin was purposely added to PBS with FBS as interference to demonstrate the capture specificity of Ab-conjugated IONPs.

The SE of anti-biofouling IONP for Aβ(1–40) in PBS with FBS at 0.1, 0.2, 0.5, 1, 2, 5, and 10 microgram/mL were.in the rage of 86-97% using fluorescence signal and with microBCA protein assay kit.   When insulin was added to Aβ(1–40) mixture, the separation efficiency of insulin for IONP was only 4.5, 4.7, 6.2, 6.5, 7.7, 9.8, and 12.3% while dynabeads showed no difference in the separation efficiency for both Aβ(1–40) and insulin.  Similar results were obtained for Aβ(1–42) and IONP with minimal isolation of insulin.  Dynabeads again showed indiscriminate separation of Aβ(1–42) and insulin.   The sensitivity for our antibody conjugated IONP detection system is calculated at 88-98.5% and false positive rate of 7.5-11.2%.  The commercial dynabeads, however, showed sensitivity of only 27-39% and false positive rate of 48.3-55.4%. 

We have developed a highly sensitive and specific Iron Oxide Nanoparticle (IONP) based system with potential application for early AD diagnosis in human serum.  Its ability to selectively detect AD markers at minute concentration and with additional benefit of low cost and scalability, it can serve as a non-invasive tool for population-wide screening for AD.  

Biography:

Assistant Lecturer at the Future University of Egypt (FUE) and NODCAR {National Organization for Drug Control and Research}. Reviewer at Bioscience reports journal, Biochemical Society (neuroscience). Eight years’ experience as QA&QC. Highly trained and qualified to deal/work on: Mesenchymal stem cells homing and developing techniques, PCR, western blotting technique, electrophoresis, Elisa, spectrophotometer, HPLC, dissolution and disintegration. Successfully trained & passed the QMS ISO 9001:2008 documentation, implantation training & internal audit.

Abstract:

Abstract

Background: Memory and learning disorders have been characterized by being a devastating long term incurable diseases with a huge social and economic impact on worldwide society in addition to a diminished efficient available medical treatments with the potential for restoring and modifying memory defects onset and drawbacks. Deep Brain stimulation via using neuroprotective inducers for restoring destructive degenerative brain structural diseases such as AD can be considered as being a promising successful therapy due to its various targets and underlying mechanisms for improving brain dysfunction by increasing synaptic plasticity and transmission. Objectives: The main aim of this study is to suggest therapeutic medical protocol with a neuroregenerative potentials having the ability to restore normal brain mechanisms and mental functions in addition to understanding triggering pathways via which normal neurons diverse population restoration process can occur. Materials and Methods: Rats were divided randomly into nine groups:(G1) control group; (G2) rats received lipopolysaccharide (LPS) injection;(G3) LPS induced rats received NaHS ;(G4) LPS induced rats received MSCs intracerebrally; (G5) LPS induced rats received MSCs+ NaHS ;(G6) LPS induced rats received kefir+Ginko Biloba (GB) ;(G7):LPS induced rats received MSCs+kefir+GB;(G8) LPS induced rats received NaHS+kefir+GB; (G9) LPS induced rats received MSCs+NaHS+kefir +GB. Results: AD induction by LPS in rats resulted in downregulation of CBS and GSH brain tissue level accompanied with overexpression in amyloid β, MAPK, Tau, ACAT and MDA brain level in addition to elevated Caspase-3 serum activity level. Conclusion: The administration of suggested medical protocol composed of MSCs and/or NaHS and/or kefir+GB resulted in relieving AD pathological deposited hallmarks with restoring the normal inflammatory brain excitatory levels by functioning as a potent neuroregenerative with the advantage of being easily implemented on human subjects as a result of its safety but with more clinical care obligations during conducting experimental design to minimize unpredictable drawbacks.

Biography:

He is working on nano-architectured drug delivery systems for effective and targeted delivery of bio-actives against the frightened disorders i.e. cancer, AD and Parkinson. He has completed master’s degree in Medicinal and Pharmaceutical Chemistry in the year 2015 from Central university of Rajasthan, India.

Abstract:

Aims: According to an estimation of WHO by 2030 after every 33 seconds one will be diagnosed with AD (Alzheimer’s Disorder) which will lead to develop 1 million new cases per year [1]. Currently there is no treatment strategy which can reverse the process of neuro-degeneration. Consequently, achieving and maintaining high therapeutic doses in clinical practices is difficult due to selective permeability of blood brain barrier (BBB). It is therefore necessary to develop safe and effective approach, which can deliver bio-actives to brain for the effective treatment of several difficult to treat brain disorders.

Objective: The purpose of the present study is to develop and characterize polyamidoamine (PAMAM)-lactoferrin (PAMAM-Lf) conjugates for the effective delivery of anti-Alzheimer’s drug to brain across BBB.

Methodology: Lactoferrin (Lf) was chemically conjugated to (PAMAM) dendrimers. Conjugation was confirmed by FT-IR, ¹H NMR, 2D-NMR spectroscopy and AFM techniques. Further, rivastigmine (RIV) was physically encapsulated to PAMAM (PAMAM-RIV) and PAMAM-Lf (PAMAM-Lf-RIV) conjugates. HPLC was used to quantify the drug loading and in vitro release was performed at physiological pH conditions. Brain targeting was also evaluated in animal model with additional behavioral studies.

Results and Discussion: Spectroscopic analysis confirmed the PAMAM-Lf conjugation, size of the conjugate was 100±3.1 nm after RIV loading and the size was increased up to 216±8.3 nm. AFM results showed the root mean square roughness (Rq) and surface roughness (Ra) are 6.31 and 5.27 nm, respectively. In vitro drug release from PAMAM-Lf-RIV conjugate was observed to be sustained and was evaluated for 100 h. Ex-vivo hemotoxicity of RIV loaded PAMAM-Lf conjugate was almost 9.8 fold lesser than the PAMAM dendrimer, 7.77 times lesser than PAMAM-RIV and 7.66 folds in comparison to naïve RIV. Bioavailability of the RIV was enhanced 7.63 folds compared to pure drug with other improved pharmacokinetic parameters. Exceptionally, the locomotor and object recognition behavior of the animals were also far improved over the naïve RIV and PAMAM-RIV which was a novel and significant change to address through this study.

Conclusion: PAMAM-Lf conjugate was developed to attain higher drug loading and effective delivery of RIV to brain. The obtained results were surprisingly in the area where very few studies with dendrimers are reported yet and it was observed that the behavioral response was improved with the delivery of RIV to brain using dendrimers. The developed dendrimeric system could be effective in brain delivery.

References: 1.     2015 Alzheimer’s disease Facts and Figures. Factsheet, Alzheimer’s Association.

Biography:

Ibrahim Bukenya is the Principal Physiotherapist of Stroke Foundation Uganda (SFU) ages 36 years. Stroke Foundation Uganda is in partnership with Stroke Rehabilitation Centre. We offer physiotherapy, Occupational therapy, Speech and Language therapy, Counseling, Nutrition and Follow-up assessment.

Abstract:

Stroke is a “brain attack”. It can happen to anyone at any time. It occurs when blood flow to an area of brain is cut off. When this happens, brain cells are deprived of oxygen and begin to die. When brain cells die during a stroke, abilities controlled by that area of the brain such as memory and muscle control are lost. There are a number of methods stroke is diagnosed. One is through a brain computed tomography (MRI) scan (brain CT scan) which can show bleeding in the brain or damage to the brain cells from a stroke. The test also can show other brain conditions that may be causing the symptoms. One can also use Medical history where the Doctor will ask you or a family member about your risk factors include high blood pressure,diabetes,heart disease and a personal or family history about stroke. Your Doctor also will ask about the signs and symptoms when they began. Diagnosis can also be done through physical examination, your doctor will check your mental alertness and your co-ordination and balance, he or she will check for numbness in your face, arms, legs, confusion, and trouble speaking and seeing clearly. Awareness of stroke can be made through the media such as TV show, radio   programs, Facebook, whatsapp, internet, YouTube; Instagram. Results may either be positive or negative. If positive the client is referred for rehabilitation and If negative further tests and scans can be done to identify the case. Diagnosis and stroke awareness has greatly helped to prevent or control stroke.

Biography:

Ömer DURSUN has his expertise in neuromusculoskeletal disorders. His special focus of interest is stroke, Parkinson’s disease and spinal disc herniations. His current research is based on developing new method for spinal disc herniation diagnosis.

Abstract:

Statement of the Problem: Although stroke and stroke related symptoms had been investigated in wide spectrum, yet variety of knowledge stands behind the curtain to be found. We consider that the temporomandibular joint dysfunction (TMJD) is one of the symptoms that mentioned above due to stroke related outcomes such as orofacial dysfunction, facial paralysis and mastication problems. Despite the orofacial symptoms due to stroke had been investigated separately these symptoms are originated from one system entitled with stomatognathic system. From this point of view our aim was to assess TMJD in patients with stroke. Methodology & Theoretical Orientation: Total 100 participants, 50 healthy and 50 who had stroke were recruited into this study. Digital caliper and algometer were used in order to assess temporomandibular joint range of motion and masticatory muscle pressure pain threshold. Labial comissure angle measurement was used for assessing facial paralysis severity. Fonseca questionnaire was used for TMJD assessment and categorization. In addition, dominant mastication shift was measured by the question that asks the pre-post stroke dominant mastication side. Findings: In intergroup comparison significant decrease was found in all temporomandibular range of motion parameters in favor of stroke group. Despite the fact that no significant difference was found between groups for the pain threshold in masticatory muscles except for middle part of the left temporalis muscle, values were higher in healthy group. As a result of intergroup examination of labial comissure angle degree, Fonseca questionnaire score, it was found that labial comissure angle and Fonseca questionnaire scores were higher in stroke group. Intragroup examination of stroke patients showed that dominant mastication side shift was seen in stroke patients. Conclusion & Significance: It was concluded that, TMJD prevalence was higher in stroke group compared to healthy group and use of modalities specific to TMJD treatment would be beneficial.

Biography:

She is working as Speech and Language therapist at Faculty of Medicine University of Kelaniya Ragama Sri Lanka.

Abstract:

Background

Early identification and referring for adequate treatments of aphasia is essential as it may cause for limitations in daily life and functional communication. But there are no currently available standardized aphasia screening tests in Sri Lankan Sinhala speaking context. The dissertation mainly focused on adapting Frenchay Aphasia Screening Test (FAST) for patients with post-stroke aphasia in the Sri Lankan Sinhala speaking context.

Materials and method

The descriptive cross-sectional study design was implemented for adapting FAST into Sri Lankan Sinhala speaking context. A purposive sampling of 90 non- impaired people and 35 aphasia patients from government hospital speech and language therapy clinic settings in the western province enlisted for the study. Study instruments were the self-administrative questionnaire for adapting and translating the tasks and interviewer administrative adapted screening tool.

Results

There was a significant negative correlation between age and total scores in non- impaired population (A Spearman's rank-order coefficient [r s ] = -.701, p< .001) and a high degree of inter-rater reliability of the adapted screening test was found (intraclass correlation coefficient [ICC]= 1.000, p<.001).

Conclusion

The newly adapted Sinhala version of FAST is a reliable and sensitive screening tool for aphasia detecting in Sri Laankan Sinhala speaking context. The elicited cut values are 28 (age 20-60), 19 (age 61-70), 14 (above 71) for each age group.

Biography:

Abstract:

Background:  An occupational therapy fitness-to-drive assessment may be required to determine if drivers in the early stages of dementia can continue to drive. Such assessments could be better tailored for clients with dementia if we had research evidence to support the

Location of assessment (open or local area), method (self-directed or directed) and whether repeat testing is required (opportunity to undertake a second test), or which combination of these factors is best for drivers with, and without navigational difficulties.

Objectives: To determine the effect of location of assessment (open or local area) and practice (undertaking more than one assessment) on pass or fail outcome for drivers both with, and without navigational problems.

Methods: 43 clients (mean age 77 SD 6.69) participated in a stratified randomised controlled trial in which the ordering and location of on-road driving tests were also randomised.  Client driving assessment outcomes were recorded as pass, condition, or fail.  Data were analysed using a generalized linear mixed effects model.

Results: Overall 9 (21%) of drivers failed and 34 (79%) passed.   The 43 participants undertook a total of 93 on-road assessments and for clients with no navigational problems 20% failed the local and 33% failed the open route tests, as opposed to 58% (local) and 55% (open) for clients with navigational problems.  Overall, participants with navigational problems were 6 times more likely to fail the on-road test: B = -1.793 (95%CI -3.265 to- 0.321), p<0.01.  The OT-Drive Home Maze Test was a significant predictor of outcome on the on-road test, with slower times predictive of fail: B = -1.14, z = -2.219, p = 0.012.

Conclusions:  Therapists can be confident that driver performance when undertaking a test is not influenced by practice or location.  However, drivers with navigational problems are more likely to fail their on-road test.

Biography:

Richa Tripathi, M.D. (Ayurveda) is persuing her PhD in Department of Kayachikitsa, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University (BHU), Varanasi, Uttar Pradesh, India. She earned MD degree in Panchakarma from Bharti Vidyapeeth University, Pune, Maharashtra in 2012. She served as assistant professor in Ayurved College, Shree Baba Mast Nath University, Asthal Bohar, Rohtak, Haryana from Aug 2012 to Feb 2014. She has served the society as an Ayurvedic physician and cancer counselor at D.S. Research Center, Varanasi, Uttarpradesh, India from feb 2014 to dec 2014. She actively campaigned for early diagnosis and cancer prevention in Varanasi and is a well-known face in local newspapers. She has done a lot of health campaign through All india Radio Pradeshik Seva for Cancer and Alzheimer’s Disease prevention. She has published many research papers in national and international journals like International Ayurvedic Medical Journal, World Journal of Pharmacy and Pharmaceutical Sciences, International Journal of Ayurveda and Pharmaceutical Chemistry, IJAAS, Medha International Interdisciplinary journal. She has presented numerous papers in national and International seminars. Her current research on Alzheimer’s Disease got noticed in Alzheimer’s Association International Conference, Chicago 2018. 

Abstract:

Background: In the anticipation of disease modifying treatments for Alzheimer’s disease, Brahmi Ghrita, a polyherbal Ayurvedic medicine traditionally used for enhancing memory and cognition, was tested on 30 diagnosed patients of mild cognitive impairment (MCI) due to Alzheimer’s disease. Donepezil, a contemporary treatment, often results in vivid side-effects. The study was conducted to compare the effect of Brahmi Ghrita and Donepezil in MCI due to Alzheimer’s.

Objectives: The objective was to investigate the cognitive response of Brahmi Ghrita on Mild Cognitive Impairment due to AD. The trial was conducted on 30 diagnosed patients of MCI due to AD. The cases were compared with same number of patients undergoing allopathic treatment of MCI (Donepezil 10mg/day and the data was evaluated with respect to score changes in ADAS- Cog scale.

Materials and Methods: It was an open label, single centered, comparative, prospective, pragmatic trial. The trial protocol and related documents were reviewed and approved by the Institutional Ethical Committee, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P., India. The study was conducted in accordance with Indian Council of Medical Research (ICMR) ethical guidelines for biomedical research on human participants. Trial had registered in the clinical trial registry of India (CTRI/2017/07/009171).Primary outcome measure of study was to evaluate efficacy of Ayurvedic formulation Brahmi Ghrita in the subjects suffering from Mild cognitive impairment due to Alzheimer’s Disease by assessing change in ADAS- cog scale and 3MS (Modified Mini Mental Examination Score) total Score. The secondary outcome measures was to evaluate the changes in inflammatory markers TNFa and IL10 in all the samples.

Total 84 patients (>40 years, either sex), with progressive decline in cognition (>6 months), a 3MS score of 79-100, without severe depressive disease were enrolled in the study. They were randomly divided into two groups - Donepezil group (DzG) and Brahmi Ghrita group (BGG). Donepezil’s dose of 5mg/day and Brahmi Ghrita’s dose of 12gm BD empty stomach were administered orally up to 12 weeks to both the groups, respectively. The efficacy of both the groups were assessed through the changes from baseline ADAS-Cog₁₁ scores and were compared.

Results: 60 patients were part of the study. Out of which 30 patients were treated with Brahmi Ghrita and the rest 30 with Donepezil (5mg/day). Statistically significant change from baseline ADAS-Cog₁₁ was observed for BG after 3 months. At week 12, 23 patients (76.6%) had stable and improved ADAS-Cog₁₁. The group where ADAS BG (p value = 0.01) was administered showed significant impact on the patients. Also, the group where ADAS DZP (p value = 0.001) was administered showed significant impact as well but diarrhea, vomiting, cramps were some associated symptoms with Donepezil. The objective parameters TNF a and IL 10 were also performed but they did not show any gross significant changes in this short duration of treatment.

Conclusions: Although the trail was of short duration but Brahmi Ghrita was found to modestly improve cognition, activities of daily living and global clinician rating of patients with mild to moderate cognitive impairment due to Alzheimer’s. The stabilizing effect of Brahmi Ghrita on cognitive ability from this explorative study suggests its promising efficacy and should be further evaluated in future studies.

Biography:

Ivan Pradhana is a 4th grade medical student in the University of Indonesia. With the help from his colleagues, Ficky Huang and Edelyne Chelsea, also from his research supervisor, Martina Wiwie, he conducted this research as a requirement for getting his bachelor degree on medicine. Before this research, Ivan collaborated with other researchers and successfully published a research with the title of Correlation of Behavioral and Psychological Symptoms of Dementia and Caregivers' Physical and Mental Health in the 20th Asia Pacific Regional Conference: Alzheimer’s Disease International 2017.

Abstract:

It is estimated that 30-50% of people with dementia (PWD) suffer from significant depression. This fact indicates that for most PWD, depression occurs at the same time as cognitive decline. Research explains that this happens because PWD cannot run their daily activities independently and they (tend to) forget many essential memories, such as their family. It is also known that the risk of depression is higher for  highly educated people. This research was conducted with the intention to find the correlation between depression score and global cognitive score in 42 PWD using the Montgomery-Asberg Depression Rating Scale (MADRS) and the Mini Mental State Examination (MMSE) to assess the symptoms of depression and the global cognitive score, respectively. PWD included in this research were only those who have an MMSE score between 17 and 23 (mild cognitive impairment), and a MADRS score below 34 (no depression, mild depression, and moderate depression). Mild depression occurred in 41 out of 42 subjects (97,6%) and the global cognitive score mean was 19,53; Therefore, depression score is strongly correlated to the global cognitive score (r=0,647, p<0,001). It is assumed that many PWD are aware of their declining cognitive ability often leading to insecurities because of their condition. Some PWD experienced apathy, loss of appetite, and sleep disturbance. Because of these discoveries, it was concluded that PWD who have higher global cognitive scores also have higher depression scores.

Biography:

He is currently doing his Ph.d. in Molecular Toxicology Laboratory, Department of Biotechnology, Bharathiar University, Coimbatore.

Abstract:

The magnetic and paramagnetic properties of iron oxide (Fe₂O₃) nanoparticles (NPs) attract the attention of clinicians for its various biomedical applications including neurodiagnostics and therapeutics. The neurotoxicity of Fe₂O₃-NPs in association with behavioural changes has already been proved, but the neurochemical changes underlying such events have not been investigated so far. Thus, this research is focused to understand the levels of monoamines such as dopamine (DA), norepinephrine (NE) and epinephrine (EP) upon exposure to Fe₂O₃-NPs.  In this study, mice were exposed to Fe₂O₃-NPs by oral intubation daily for 30 days.  The levels of DA, NE and EP were found to be altered in the subjected brain regions in correspondence to the expression of monoamine oxidases (MAO). In addition, increased intracellular calcium (i[Ca²⁺]) and decreased expression of growth associated protein 43 (GAP43) indicate the impaired vesicular exocytosis. Further, enormous lipid peroxidation of the treated brain regions and axonal demyelination might affect the normal impulse conduction. This background information accounting all these events could open further avenues to unravel the entire nexus between Fe₂O₃-NPs and neurotoxicity and behavioural changes.

Biography:

Abstract:

Introduction: Periodic paralysis is a group of rare neuromuscular disorders presenting with episodes of painless paralysis often incited by stress such as exercise. Differentiating hypokalemic periodic paralysis (HPP) from secondary hypokalemia can present a challenge. Case Report: A 26-year-old Hispanic male with no significant past medical history presented with periodic muscular weakness, areflexia, and paralysis. The patient’s potassium level on admission was 1.6 mEq/l with no other electrolyte abnormalities or electrocardiogram changes. There was a complete resolution of symptoms with IV and oral potassium. The diagnosis of acquired non-thyrotoxic HPP was given based on the patient’s history, his presenting symptoms, ruling out secondary causes of hypokalemia, and resolution with correction of potassium levels. Conclusion: Hypokalemic periodic paralysis most commonly affects Asians, and is tightly associated with thyrotoxicosis. Treatment of HPP relies on rapid identification and understanding of underlying cause. In an acute disabling attack, as seen in this patient, oral potassium and 24 hour cardiac monitoring for rebound hyperkalemia are recommended. We report an uncommon case of acquired non-thyrotoxic HPP, as indicated by the patient’s history, presentation, initial laboratory values, and resolution after potassium correction. Keywords: Muscular weakness, Non-thyrotoxic hypokalemic, Periodic paralysis, Potassium level.

Biography:

Abstract:

Background: Atherosclerotic changes of the carotid vessel frequently underlie carotid-related cerebrovascular ischemic events. Carotid intima-media thickness (IMT) is a validated measure of atherosclerosis burden. Increased C-IMT and atherosclerotic plaques are associated with the subsequent risk of new or recurrent stroke and myocardial infarction. This study aims to find out the carotid IMT in ischemic stroke patient and its correlation with the severity of the stroke and various risk factors of the stroke like diabetes, hypertension, dyslipidemia, family history of ASCVD, smoking etc.

Methods: A cross sectional, hospital-based study was carried out from March 2014 to February 2015 at Tertiary hospital, Kathmandu. Carotid IMT was measured by high-resolution B-mode ultrasound.

Results: A total of 62 patients with ischemic stroke were enrolled in this study. The age distribution varied from 41 to 85 years. Mean C-IMT on Right side was 1.1468 mm (SD 0.375), whereas mean CIMT on left side was 1.137 mm (SD 0.35). Majority 85.5 % had Mean IMT > 0.8 mm. 51.6% had IMT between 1-1.5 mm. Patient with single risk-factor had CIMT of 1.0526mm (SD 0.3), with no risk factors 0.0912 (SD 0.4) and with multiple risk factors had CIMT of 1.2628 (SD 0.404), the difference was statistically significant. Change in IMT on the ipsilateral side of the stroke with the IMT of the opposite side was significant (p value <0.05). This study found the significant association of CIMT with severity of clinical presentation and presence of one or more risk factors, strong correlation was seen with hypertension, diabetes, dyslipidemia, raised total cholesterol and high LDL cholesterol.

Conclusion: Our study reveals the importance of carotid IMT evaluation at the patients with atherosclerotic risk factors and suggests a predictive role of increased carotid IMT for ischemic stroke with severe clinical presentation and presence of other risk factors.